AJOB Empirical Bioethics最新文献

{"title":"'Why Do You Ask?' Revisiting the Purpose of Eliciting the Public's Moral Judgments About Emerging Technologies.","authors":"Jared N Smith, Anne Barnhill, Julian Savulescu, S Matthew Liao, Matthew S McCoy, Jennifer Blumenthal-Barby","doi":"10.1080/23294515.2025.2474911","DOIUrl":"https://doi.org/10.1080/23294515.2025.2474911","url":null,"abstract":"<p><p>It is increasingly common for bioethicists to consult with the public to solicit their judgments and attitudes about ethical questions and issues, especially ones that arise with new and emerging technologies. However, it is not always clear what the purpose of this engagement is or ought to be: do bioethicists seek the input of the public to help them arrive at a morally correct justified policy position, or do they seek this input to help them shape and frame their already-established moral position, or something else entirely? In this essay, we discuss four distinct possible functions of collecting moral judgments from the public: issue spotting, messaging for adherence and social stability, substantive moral guidance, and procedural fairness. For each function, we offer core examples from the literature before discussing the strengths and weaknesses attendant to each. We conclude with several preliminary questions bioethicists can ask themselves to clarify their own purpose for soliciting moral judgments from the public.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'An Unimaginable Challenge': A Cross-Cultural Qualitative Study of Ethics and Decision-Making Around Tracheostomy Ventilation in Patients with Amyotrophic Lateral Sclerosis.","authors":"Reina Ozeki-Hayashi, Dominic J C Wilkinson","doi":"10.1080/23294515.2025.2474928","DOIUrl":"https://doi.org/10.1080/23294515.2025.2474928","url":null,"abstract":"<p><strong>Background: </strong>The rate of tracheostomy with invasive ventilation (TIV) for patients with Amyotrophic Lateral Sclerosis (ALS) varies widely. Previous studies have shown that doctors' values may affect decision-making. There have been no previous international qualitative comparisons of medical decision-making process for TIV or why practice varies.</p><p><strong>Methods: </strong>We conducted semi-structured in-depth interviews with 16 doctors actively involved in the management of ALS patients from Japan (<i>n</i> = 7), the UK (<i>n</i> = 5), and the US (<i>n</i> = 4). We used three hypothetical cases to explore decision-making. Conversations were transcribed and thematically analyzed.</p><p><strong>Results: </strong>Our data reveals similarities but also marked differences in views between the US, the UK and Japan. Almost all participants stated that they ought to respect patient autonomy. However, their approaches varied. British participants wanted to (and felt that they should) respect patient autonomy, but they also believed that TIV was not a realistic option. US participants were likely to prioritize patient autonomy over other ethical principles, and Japanese participants were likely to limit patient autonomy indirectly. The option of TIV appeared to be heavily influenced by the availability of healthcare resources in all three countries. The high cost, limited availability and difficulty of treatment meant that particularly in the UK and the US, it is challenging to receive TIV even if patients wanted this.</p><p><strong>Conclusions: </strong>Our study illustrates how the emphasis on autonomy varies along with variations in the way care is organized in the setting of highly resource intensive treatment and progressive severe disabling illness. There is a need to review elements of the decision-making process in all three countries. This includes the need for transparent, ideally centralized, decision-making guidelines about the provision of TIV. Although we investigated a rare neuromuscular disease, our results will be relevant to other diseases requiring highly resource-intensive treatment toward the end of life.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is It a Bribe? Research Personnels' Perceptions of the Ethical Aspects of Financial Compensation to Healthy Volunteers in Prevention Trials in Tanzania.","authors":"Raymond Athanas, Gasto Frumence, Rebecca J DeBoer, Connie M Ulrich","doi":"10.1080/23294515.2025.2474910","DOIUrl":"https://doi.org/10.1080/23294515.2025.2474910","url":null,"abstract":"<p><strong>Background: </strong>Financial compensation may be perceived as a catalyst to increase the recruitment and retention of healthy volunteers in clinical trials but also potentially as a form of undue inducement. The ethical guidelines in Tanzania, while helpful, are not clear on what is considered reasonable compensation for healthy volunteers and the extent to which it influences participation. This study aimed to explore research personnels' perceptions of the ethical aspects of financial compensation to healthy volunteers participating in prevention trials in Tanzania.</p><p><strong>Methods: </strong>Qualitative semi-structured interviews were conducted in Tanzania with a purposive sample of 36 research personnel with different project roles ranging from principal investigators (PIs) to study staff on six prevention trials. The interviews were recorded and transcribed verbatim and thematic analysis was performed.</p><p><strong>Results: </strong>Most research personnel were physicians (64%) and male (67%) with a mean age of 48 years. Three qualitative themes were identified: ethical justifications for financial compensation, ethical concerns about financial compensation and fair compensation as income. Most Tanzanian research personnel were more aligned with the view that financial compensation is an ethical responsibility in respecting the value of a healthy volunteer's time and effort, especially for those who face barriers to participation, rather than being a bribe. However, there were those who raised ethical concerns about financial compensation that included perceptions of bribing low-income earners and increased misperceptions of trial activities. Research personnel also indicated that the specific amount of financial compensation has ethical implications. Amounts that were either too much or too little were viewed as unethical, whereas a modest rate was perceived as ethical.</p><p><strong>Conclusions: </strong>Paying healthy volunteers is a measure of respect and supported by the national Tanzanian research guidelines. However, a reevaluation of these research ethical guidelines to redefine reasonable, fair and just financial compensation, especially for those who face significant barriers to participation, would continue to respect healthy volunteers and provide regional guidance for researchers within the country.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Presence in Pediatric Cardiac Procedural Settings: A Qualitative Study of Clinicians, A Key Stakeholder Group.","authors":"Zoel A Quiñónez, Kimberly A Pyke-Grimm, Shreya K Kamra, Kate E Holmes, Danton Char","doi":"10.1080/23294515.2025.2474918","DOIUrl":"https://doi.org/10.1080/23294515.2025.2474918","url":null,"abstract":"<p><strong>Background: </strong>With increased emphasis on healthcare transparency, parents are increasingly asking to be present for procedures performed on their children, especially in high-acuity contexts like care of children with congenital heart disease (CHD), where procedures may inform critical care decisions. In addition, observations of complex care may better communicate clinical knowledge and benefit grieving after adverse events. We examined clinicians' views on current family presence (FP) efforts and on the expansion of FP to include the observation of operative procedures.</p><p><strong>Methods: </strong>This is a qualitative study using semi-structured interviews and content analysis within a pediatric heart center. Participants included perioperative and ICU nurses, physicians, advanced practice providers, and child life specialists. Interviews were recorded, transcribed, and analyzed using inductive content analysis.</p><p><strong>Results: </strong>Twenty provider interviews were conducted; 70% had less than 10 years of experience, with 30% having between 10 and 20 years; 50% were physicians who work in procedural environments; 25% were nurses; 15% were advanced practice providers; 10% were child-life specialists. Four categories emerged: (1) positive impact of FP, (2) negative impact of FP, (3) limitations to achieving FP, and (4) policies and procedures for FP.</p><p><strong>Conclusion: </strong>Participants reported that current FP uses reduce patient anxiety and improve patient safety, family understanding of clinical decisions, and coping. Drawbacks include parental interference in care, lack of protocols to guide FP, increased family/staff anxiety, lack of staff resources to support FP, and potential access limitations for diverse populations. Participants anticipated that these problems would occur with the expansion to intraoperative FP.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Emotional Impact of Clinical Ethics Work on Clinical Ethicists: A Qualitative Study.","authors":"Anna D Goff, Marsha M Michie, Marcie A Lambrix, Monica L Gerrek","doi":"10.1080/23294515.2025.2474912","DOIUrl":"https://doi.org/10.1080/23294515.2025.2474912","url":null,"abstract":"<p><strong>Background: </strong>The experiences of clinical ethicists have recently begun to garner some attention, but very little is known about the emotional impact of clinical ethics work on clinical ethicists. The purpose of our study was to explore the experiences of clinical ethicists in the United States in order to better understand the impact that their professional responsibilities have on them as people, as well as to learn about the ways in which organizational structures and coping mechanisms help them navigate the emotional impact of their work.</p><p><strong>Methods: </strong>This was a primary analysis of 34 semi-structured interviews with clinical ethicists across the United States. The interviews were conducted from May-September 2023 and were recorded, transcribed, and de-identified. The qualitative themes explored in this paper are part of a larger study informed by principles derived from grounded theory.</p><p><strong>Results: </strong>Four major themes emerged: particular features of clinical ethics work seem to significantly impact the emotional state of clinical ethicists, lack of clarity about the role of clinical ethicists appears to significantly impact their emotional experience, organizational structures appear to shape clinical ethicists' professional and emotional experiences, and clinical ethicists employ a variety of professional and personal coping mechanisms when experiencing adverse emotions because of their professional responsibilities.</p><p><strong>Conclusion: </strong>Our findings suggest that clinical ethicists are profoundly impacted by their work and that their emotional experience is shaped by a wide range of factors both at the individual and systemic level.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whether to Offer Interventions at the End of Life: What Physicians Consider and How Clinical Ethicists Can Help.","authors":"Joelle Robertson-Preidler, Mikaela Kim, Sophia Fantus, Janet Malek","doi":"10.1080/23294515.2025.2457705","DOIUrl":"https://doi.org/10.1080/23294515.2025.2457705","url":null,"abstract":"<p><strong>Background: </strong>Advances in life-prolonging technologies increasingly create dilemmas for physicians who must decide whether to offer various interventions to patients nearing the end of life. Clinical ethicists are often consulted to support physicians in making these complex decisions and can do so most effectively if they understand physicians' reasons for making recommendations in this context.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with surgeons, nephrologists, intensivists, emergency physicians, and oncologists regarding the considerations they have used to make decisions about offering interventions for patients nearing the end of life. Interview transcripts were thematically analyzed.</p><p><strong>Results: </strong>We identified six types of considerations physicians take into account: (1) patient characteristics at baseline; (2) likelihood to cause harm; (3) likelihood to achieve a goal or perceived benefit; (4) patient and family values and preferences; (5) institutional factors, and (6) professional and personal factors.</p><p><strong>Conclusions: </strong>While considerations converged into major themes, many participants evaluated and applied these themes differently, opening the door to potential disagreement and variation based on physicians' personal values. Clinical ethicists can help navigate uncertainty and resolve conflicts by helping physicians recognize, evaluate, and communicate their decisional factors to aid informed decision-making.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Ethics Fellowship Programs in the United States and Canada: Program Directors' Opinions About Accreditation and Funding.","authors":"Ellen Fox, Jason Adam Wasserman","doi":"10.1080/23294515.2024.2388516","DOIUrl":"10.1080/23294515.2024.2388516","url":null,"abstract":"<p><p>To succeed, an accreditation process for clinical ethics fellowship programs (CEFPs) would need support from CEFP directors. To assess CEFP directors' opinions, we surveyed all 36 CEFP directors in the United States and Canada, achieving a 100% response rate. We found that support for accreditation is strong, with 30.6% strongly supportive, 44.4% supportive, 22.2% neutral, 2.8% opposed, and 0% strongly opposed. Most directors (77.8%) would be likely to apply for accreditation within the next five years regardless of the availability of government funding; even more (86.1%) would apply if government funding became available for accredited programs. Most directors thought that lack of a national accreditation process (75.0%), lack of agreed-upon standards (90.0%), and lack of funding for CEFPs (91.7%) were at least moderate problems for the field. When directors were asked what they thought was the greatest challenge or barrier to developing an accreditation process, many mentioned the diversity of programs and the challenge of achieving consensus on accreditation standards. Directors offered a variety of suggestions for how to overcome or manage challenges or barriers, including collecting data on existing programs, mirroring standards established for other health professions, and setting clear expectations on the need for compromise. When directors were asked how they expected that accreditation and government funding would affect their own programs, the field of clinical ethics, and patient care, directors mostly had very positive expectations; no director expected negative effects in any of these areas. Overall, this study provides evidence that developing an accreditation process for CEFPs would be both possible and desirable. Our findings have immediate practical implications for the field and will inform efforts that are already underway to establish an accreditation process for CEFPs.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Issues in Implementation Science: A Qualitative Interview Study of Participating Clinicians.","authors":"Justin T Clapp, Naomi Zucker, Olivia K Hernandez, Ellen J Bass, Meghan B Lane-Fall","doi":"10.1080/23294515.2024.2388537","DOIUrl":"10.1080/23294515.2024.2388537","url":null,"abstract":"<p><strong>Background: </strong>Implementation science presents ethical issues not well addressed by traditional research ethics frameworks. There is little empirical work examining how clinicians whose work is affected by implementation studies view these issues. Accordingly, we interviewed clinicians working at sites participating in an implementation study seeking to improve patient handoffs to the intensive care unit (ICU).</p><p><strong>Methods: </strong>We performed semi-structured interviews with 32 clinicians working at sites participating in an implementation study aiming to improve patient handoffs from the operating room to the ICU. We analyzed the interviews using an iterative coding process following a conventional content analysis approach.</p><p><strong>Results: </strong>Clinicians' greatest concern about involvement was possible damage to interpersonal relations with more senior clinicians. They were divided about whether informed consent from clinicians was necessary but were satisfied with the study's approach of sending out mass communications about the study. They did not think opting out of the implementation portion of the study was feasible but saw this inability to opt out as unproblematic because they equated the study with routine quality improvement. Those clinicians who helped launch the study at their sites recounted several different ways of doing so beyond simply facilitating access.</p><p><strong>Conclusions: </strong>The risks that clinicians identified stemmed more from their general status as employees than their specific work as clinicians. Implementation researchers should be attuned to the ethical ramifications of involving employees of varying ranks. Implementation researchers using hybrid designs should also be sensitive to the possibility that practitioners affected by a study will equate it with quality improvement and overlook its research component. Finally, the interactions that go into facilitating an implementation study are more various than the \"gatekeeping\" typically discussed by research ethicists. More research is needed on the ethics of the myriad interactions that are involved in making implementation studies happen.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"22-31"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Stewardship: Funding, Utilization, and Sustainability as Ethical Concerns in Networked Biobanking.","authors":"R Jean Cadigan, Roselle Ponsaran, Carla Rich, Josie Timmons, Kyle B Brothers, Aaron J Goldenberg","doi":"10.1080/23294515.2024.2399533","DOIUrl":"10.1080/23294515.2024.2399533","url":null,"abstract":"<p><strong>Background: </strong>The literature on the ethics of biobanking often overlooks the practical operations of biobanks. The ethics of stewardship requires that biobank resources are used to conduct beneficial science. Networked biobanks have emerged to increase the scientific benefit of biobank resources, but little is known about whether and how operations of networking may accomplish this goal.</p><p><strong>Methods: </strong>As part of a larger study on the ethical, legal, and social implications (ELSI) of networked biobanking, we conducted 38 interviews with representatives of 31 networked biobanks. Interviews explored operations of the networks. We used thematic analysis to examine how respondents describe three topics associated with stewarding biobank resources-funding, utilization, and sustainability.</p><p><strong>Results: </strong>Our results highlight that funding, utilization, and sustainability are critical not only to the operation of biobanks, but also to the ethical obligations that biobankers owe to stakeholders to steward the resources. Based on prior research, we hypothesized that respondents would describe networking as beneficial to increasing funding, utilization, and sustainability of the network. Respondents generally found value in networked biobanking, but networking did not necessarily increase funding, utilization, and sustainability.</p><p><strong>Conclusion: </strong>The results presented here support inclusion of funding, utilization, and sustainability as topics of ethical concern in the practice of biobanking and networked biobanking. These issues are rooted in the stewardship obligations that biobankers feel to their partners, client investigators, and participants. The goal of promoting stewardship through networking requires significant time and effort to build governance models that honor the obligations of each individual biobank to their donors and advance the collective goals of the network. We conclude with suggestions offered by respondents to address improving these aspects of stewardship.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"42-51"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Brain Stimulation for Childhood Treatment-Resistant Obsessive-Compulsive Disorder: Mental Health Clinician Views on Candidacy Factors.","authors":"Ilona Cenolli, Tiffany A Campbell, Natalie Dorfman, Meghan Hurley, Jared N Smith, Kristin Kostick-Quenet, Eric A Storch, Jennifer Blumenthal-Barby, Gabriel Lázaro-Muñoz","doi":"10.1080/23294515.2024.2399519","DOIUrl":"10.1080/23294515.2024.2399519","url":null,"abstract":"<p><strong>Introduction: </strong>Deep brain stimulation (DBS) is approved under a humanitarian device exemption to manage treatment-resistant obsessive-compulsive disorder (TR-OCD) in adults. It is possible that DBS may be trialed or used clinically off-label in children and adolescents with TR-OCD in the future. DBS is already used to manage treatment-resistant childhood dystonia. Evidence suggests it is a safe and effective intervention for certain types of dystonia. Important questions remain unanswered about the use of DBS in children and adolescents with TR-OCD, including whether mental health clinicians would refer pediatric patients for DBS, and who would be a good candidate for DBS.</p><p><strong>Objectives: </strong>To explore mental health clinicians' views on what clinical and psychosocial factors they would consider when determining which children with OCD would be good DBS candidates.</p><p><strong>Materials and methods: </strong>In depth, semi-structured interviews were conducted with <i>n</i> = 25 mental health clinicians who treat pediatric patients with OCD. The interviews were transcribed, coded, and analyzed using thematic content analysis. Three questions focused on key, clinical, and psychosocial factors for assessing candidacy were analyzed to explore respondent views on candidacy factors. Our analysis details nine overarching themes expressed by clinicians, namely the patient's previous OCD treatment, OCD severity, motivation to commit to treatment, presence of comorbid conditions, family environment, education on DBS, quality of life, accessibility to treatment, and patient age and maturity.</p><p><strong>Conclusions: </strong>Clinicians generally saw considering DBS treatment in youth as a last resort and only for very specific cases. DBS referral was predominantly viewed as acceptable for children with severe TR-OCD who have undertaken intensive, appropriate treatment without success, whose OCD has significantly reduced their quality of life, and who exhibit strong motivation to continue treatment given the right environment. Appropriate safeguards, eligibility criteria, and procedures should be discussed and identified before DBS for childhood TR-OCD becomes practice.</p>","PeriodicalId":38118,"journal":{"name":"AJOB Empirical Bioethics","volume":" ","pages":"32-41"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}